Hospitalists Less-Likely Targets of Malpractice Claims Than Other Physicians

A new study in the Journal of Hospital Medicine reports that hospitalists in internal medicine are subjected to medical malpractice claims less frequently than other internists or physicians in other specialties.

In the article "Liability Impact of the Hospitalist Model of Care," Adam Schaffer, MD, a hospitalist at Brigham and Women's Hospital in Boston, writes that hospitalists average 0.52 malpractice claims per 100 physician coverage years (PCYs), while non-hospitalist internal medicine physicians have a rate of 1.91 claims per 100 PCYs. By comparison, ED physicians average 3.5 claims per 100 PYCs, general surgeons average 4.7 claims, and OB/GYNs average 5.56 claims (P<0.001 for all comparisons).

"I was fairly surprised because the magnitude of the decreased risk…was fairly significant and statistically significant," Dr. Schaffer says. He notes that having relatively short interactions with patients and the difficulties of care transitions would appear to make it difficult for hospitalists to establish the type of close relationships with patients that can help prevent malpractice claims. However, hospitalists have overcome that hurdle.

An editorial that accompanies the JHM study contends that hospitalists develop and hone skills "which allow them to quickly establish rapport with patients and families." The editorial was penned by hospitalist Kevin O'Leary, MD, MS, SFHM, of Northwestern University Feinberg School of Medicine in Chicago, and JHM Editor-in-Chief Andrew Auerbach, MD, MPH, SFHM, of the University of California, San Francisco.

"Even though you may have a relatively brief relationship with the patient," Dr. Schaffer adds, "the fact that you're in the hospital, able to see them, meet with them, answer their questions multiple times a day if need be, that may actually help establish a strong and robust physician-patient relationship."